Breast lump - Diagnosing a breast lump

It is important to be aware of how your breasts usually look and feel so you can quickly pick up on any changes that may occur.

See your GP if you notice a lump in your breast or any change in its appearance, feel or shape. Your GP may ask a number of questions, including:

• When did you first noticed the lump?
• Do you have other symptoms, such as pain or a discharge from your nipple?
• Do your symptoms change with your menstrual cycle?
• Have you ever injured your breast?
• Do you have any risk factors for breast cancer, such as a close family member who has had breast cancer?
• What medications are you currently taking?
• Are you currently breastfeeding, or have done in the past?

Your GP will also carry out a physical examination of both your breasts, with your permission. 

If it makes you feel more comfortable about being examined, you can bring a friend or a family member with you. But your GP should ask you whether you'd like another staff member – such as a practice nurse – to be present while your breast is being examined.

After asking about your symptoms and examining your breasts, your GP may refer you for further tests to confirm the cause of the lump.

Being referred for further testing can be scary, but it is important to remember that this is routinely done and it does not necessarily mean your GP thinks you have breast cancer. Most people who have these further tests are eventually found to have a benign (non-cancerous) condition.

The main tests you may have are described below.

Mammogram

A mammogram is a simple procedure that uses X-rays to create an image of the inside of your breasts.

It can help identify early changes in your breast tissue. Younger women usually have denser breasts than older women, which makes changes more difficult to identify.

This means that mammograms are not as effective in women under the age of 40. If you are under 40, your GP may suggest you have a breast ultrasound instead.

If you need to have a mammogram, a radiographer (an X-ray specialist) will position one of your breasts on a flat X-ray plate.

A second X-ray plate will press down on your breast from above so it is temporarily flattened between the two plates. An X-ray will then be taken, which will produce a clear image of the inside of your breast.

After the first X-ray has been taken, the same procedure will be carried out on your other breast.

A mammogram only takes a few minutes to carry out, but you may find it a bit uncomfortable or even slightly painful. After the procedure is complete, the image of your breast will be examined for anything unusual.

Ultrasound scan

If you are under the age of 40, a breast ultrasound scan may be recommended because your breast tissue may be too dense for a mammogram.

However, women over 40 will often have both a mammogram and breast ultrasound scan to investigate a breast lump.

Your doctor may also suggest you have a breast ultrasound scan if they need to know whether a lump in your breast is solid or contains liquid.

Ultrasound scans use high-frequency sound waves to produce an image of the inside of your breasts. An ultrasound probe or sensor will be placed over your breasts to create an image on a monitor. The image will highlight any lumps or abnormalities that may be present.

Biopsy

You may need a breast biopsy if the cause of your breast lump cannot be diagnosed using a mammogram or ultrasound scan. A biopsy is a procedure that involves removing a tissue sample from the lump for further testing. 

To obtain the sample, a hollow needle is inserted through your skin and into the area being examined. Ultrasound scans or X-rays will be used to help the doctor or surgeon guide the needle to exactly the right place.

When the needle is in position, it will "suck out" a sample of tissue. A local anaesthetic will usually be used to numb the area so you won't feel pain or discomfort.